Incomplete aspirin desensitization in an aspirin-sensitive asthmatic

Aspirin desensitization is a valuable treatment for aspirin-sensitive sinusitis. We present a case where long-term desensitization failed. While undergoing desensitization, our patient had prolonged severe asthmatic reactions and therefore received high intravenous doses of prednisone. We hypothesize that high steroid doses administered at the time of desensitization may have raised the threshold of intolerance to a point where the administered aspirin doses were tolerated. Consequently, symptoms of intolerance subsided during the procedure. Subsequent tapering down of the daily prednisone dose caused a re-emergence of the symptoms of intolerance, apparently due to a decrease in the intolerance threshold.